Adolescent ; Adult ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Orbit ; surgery ; Orbital Fractures ; surgery ; Otorhinolaryngologic Surgical Procedures ; Treatment Outcome ; Young Adult

Objective To report the results of the surgical treatment of cervical spondylotic myelopathy(CSM) secondary to athetoid cerebral palsy and clarify the characteristics and the principle of treatment of the disease. Methods The age of the patient, segments of vertabrae involved and operated upon, results and complications of 32 cases with CSM secondary to athetoid cerebral palsy were statistically analyzed and compared with 93 patients who had isolate CSM operatively treated at the same time. Results 1)The average age of the patients in the group of CSM secondary to athetoid cerebral palsy was 37.94 years,and in the group of isolate CSM was 52.48 years, with significant statistic difference(P

Objective:To observe the clinical effect of different background volumes of ropivacaine in continuous tibial nerve block of postoperative analgesia after calcaneal surgery.Methods:This study was a prospective,randomized,controlled study.Sixty cases of calcaneal visual analogue scale (ASA)ⅠorⅡundergoing elective surgery were selected and randomly assigned to two groups,thirty cases in each group.The patients received popliteal fossa posterior tibial nerve block using ultrasound guided.The con-tinuous stimulation catheter was inserted after successful position and the 0.2%ropivacaine was injected. The background volumes of the A and B groups were 5 mL/h and 3.2 mL/h.The VAS score,the senso-ry block and motor block of tibial nerve and common peroneal nerve,and the satisfaction of the patients at h 12,h 24 and h 48 were recorded after catheter insertion.Results:The VAS scores at the three time points (h 12,h 24 and h 48)on the two groups of the patients were compared,and the difference was not statistically significant (P >0.05).The difference of the sensory block and the motor block of the tibial nerve at the three time points (h 12,h 24 and h 48)on the two groups of the patients were also compared,and the difference was not statistically significant (P>0.05).The difference of the sensory block and the motor block of common peroneal nerve at h 48 hs was statistically significant,group A was higher than the group B (P<0.05).The difference of the patient satisfaction at the three time points (h 12,h 24 and h 48)on the two groups was not statistically significant (P>0.05).Conclusion:The use of 0.2% ropivacaine with the background volume of 3.2 mL/h in continuous tibial nerve block can pro-vide good analgesia and reduce the incidence of the sensory block and motor block of the common perone-al nerve.

Objective To compare the reproducibility and reliability of facial soft tissue landmarks using a direct and an indirect placement methods in facial three-dimensional (3D) soft tissue assessment.Methods 3D coordinates of 37 soft tissue landmarks were obtained respectively in 35 normal healthy volunteers from 3D optical capture system and Materialise's interactive medical image control system (Mimics).Landmarks were affixed on the cutaneous surface (direct method) and marked on the 3D reconstructed craniofacial model (indirect method).Intra-class correlation coefficients (ICCs) and paired t-tests were used to compare the reliability and reproducibility of facial landmarks between two placement methods.Results For the direct placement method,86.5 ％ landmarks had an ICC higher than 0.75.For the indirect placement method,75.7％ landmarks had an ICC higher than 0.75.The inter-observer variability using the direct placement method was (1.259±0.566) mm,which was significantly smaller (P＜0.05) than (1.420±0.638) mm obtained by the indirect placement method.Conclusions Compared with indirect method,direct method has higher reliability and reproducibility in evaluating facial soft tissue.

Objective To describe an intelligent three-dimensional technique for automatic visualization of the fetal cranial mid-sagittal view to allow for the differential diagnosis of fetal midline anomalies.Methods Two hundred and twenty pregnant women with singleton pregnancies were imaged to display the mid-sagittal view of fetal head using a new 3D program (Smart MSP) developed by our team.Results The mid-sagittal view of the fetal head was successfully visualized in 190 normal cases (95％) and 18 abnormal cases (90％) by Smart MSP program.The total successful rate was 94.5％ (208/220).Conclusions Smart MSP is a novel and feasible method for the automatic visualization of fetal cranial midsagittal plane and may become a potential tool for routinely screening the fetal midline anomalies.

Acute Disease ; Humans ; Male ; Middle Aged ; Thrombocytopenia ; chemically induced ; Tyrosine ; adverse effects ; analogs & derivatives

Objective Objective To analysis the clinical curative effect on elderly patients with choledocholithiasis by endoscopic retro-grade cholangiopancreatography ( ERCP) and endoscopic sphincterotomy ( EST) and discuss its clinical significance. Methods 256 patients with choledocholithiasis were collected for diagnosis and treatment by ERCP. The stone characteristics was mastered by ERCP and the pa-tients were treated with EST. Results Patients with choledocholithiasis were successful in 249 cases (97. 27%) for ERCP intubation and 239 cases (93. 36%) for stone remove. After EST,the stones were removed successfully at one time in 199 cases (83. 26%),2 times in 40 cases (16. 74%). 7 patients (2. 73%) with multiple diverticulum and papillary position poor by intubation failure were changed over to op-eration treatment. After ERCP,patients were performed endoscopic nasobiliary drainage (ENBD) 64. 44% (154/239). Pull out the drain-age tube of 90. 91% (140/154) of the patients after stones disappeared which was proved by angiography for 3~5 days. 14 cases (9. 09%) were performed second times to remove the stones due to the presence of residual stones. Postoperative complications occured in 15 cases (6. 02%) including 9 cases of acute pancreatitis and 6 cases of infection of biliary tract, and they were cured after 1 week of corresponding treatment. Transient increase of serum amylase occurred in 39 cases, and all of them recoveried after 3 days without special treatment. Con-clusion The results showed that ERCP ( or EST) were well tolerated by elderly patients with choledocholithiasis,and they were of obvious curative effect and quick recovery,which is worthy of promotion and application.

Objective To study the effectiveness of comprehensive control measures based on systematic ecological system construction to interrupt the transmission of schistosomiasis in hilly endemic regions in Sichuan Province ,so as to provide the ev?idence for adjustment of schistosomiasis prevention and control strategies. Methods A high endemic area of schistosomiasis, Panao Township of Dongpo District in Meishan City,was selected as a demonstration area. The comprehensive measures for schistosomiasis control with focus on systematic ecological management were implemented,and the income of residents,index?es of schistosomiasis control effect and so on were investigated before and after the intervention and the results were compared. Results The project based on systematic ecological system construction started in 2009 and 317.351 million Yuan was put into the construction. The construction included economic forest plant base(1 866.68 hm2,72.66%of the total farmland areas),eco?logical protection gardens(585.35 hm2)and so on. Totally 97.04% of historical areas with Oncomelania hupensis snails were comprehensively improved. In 2015,the peasants' pure income per capita increased 4 938 Yuan,with the average annual growth rate of 14.69%. All the farm cattle were replaced by the machine. The benefit rate of water improvement was increased by 52.84%and the coverage rate of harmless toilets increased by 18.30%. The positive rate of serological tests for schistosomiasis decreased from 7.69%to 3.50%,and the positive rate of parasitological tests decreased from 1.18%to 0. The area with snails was decreased from 23.33 hm2 to 0. The awareness rate of schistosomiasis control knowledge and correct behavior rate of the resi? dents increased from 85.50%and 82.60%to 95.70%and 93.90%respectively. Conclusions The comprehensive schistosomia?sis control measures based on systematic ecological management are conform to the currently actual schistosomiasis prevention and control work in hilly endemic regions,and have good ecological economic benefit and schistosomiasis control effectiveness, which provide an effectively new model of prevention and control for advancing process,consolidating the effect,finally realiz?ing goal of interruption and elimination of schistosomiasis in hilly endemic regions.

Objective an experimental animal model of acute myoc ardial infarction (ANI) was established by opening chest and ligation of the left anterior descending (LAD) coronary artery． Methods a total of 20 rabbits were opened chest and ligated LAD under sterilization． Electrocardiogram (ECG) and myocardial-enzymes in blood serum were investigated． Results ECG of all rabbi t s showed normal before operation． Irmediately after and 1/2 hour after ligation , ST-segment elevated and ECG showed ambulatory changes for 7 and 9 rabbits respectively． Two hours after LAD ligation, the change of ECG for 2 rabbits wa s not typical and 2 of them died during experiment． Four weeks after operation, E CG of 18 rabbits showed the chest leads had pathologic Q waves． Twenty-four ho urs after LAD ligation, AST, LDH, LDH-1, CK and CK-MB in blood serum were significantly increased． There was significant difference compared with before operation (except LDH) (P<0. 0l)． Conclusions:The method was sim ple and well repeated． The formation of myocardial infarction was reliable and rabbits were maintained for a long time after operation． It provides a valuable animal mode l for the experiment study of coronary heart disease．

Medical postgraduates are the future core force of clinical diagnosis and treatment,scientific research,education and sanitary administration.Therefore,to cultivate qualified professionals,the key of contemporary medical postgraduate education is to pay more attention to comprehensive quality training in order to make students adapt to the continuous development of society and medical model.The First Clinical College in Wuhan University has implemented the hospital administration internship in combination with social needs and explored the education model of contemporary medical students with comprehensive quality.